Department of Health Systems & Quality Management, College of Public Health & Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.
Graduate School of Professional Studies, St. Mary's University of Minnesota, Minneapolis, MN, USA.
BMC Health Serv Res. 2018 Jun 15;18(1):454. doi: 10.1186/s12913-018-3247-y.
Cancelation of same-day surgery is a common global problem, wasting valuable hospitals' operating room (OR) times and imposing significant economic costs. There is limited evidence to support the association between frequency of same-day surgery cancelation and patient demographics, time-related variables, healthcare provider reasons for cancelation, and clinical procedures in Saudi Arabia. The aim of this study was to explore this relationship, providing an understanding of the local context.
A retrospective cross-sectional study that retrieved medical records to examine the association between the frequency of same-day surgery cancelation and covariates including patient demographics, time-related variables, healthcare provider reason for cancelation, and clinical procedures. The data covered from January 2014 to December 2014 at King Fahad National Guard Hospital in Riyadh. We considered 440 patients that met the inclusion criteria for final analysis. The cancelation was regarded less frequent if a patient canceled once in the12 months and more frequent if a patient canceled two times or more in the same period. We used descriptive statistics to summarize data and employed a probit regression to estimate the association of frequency of same-day surgery cancelation and covariates via maximum likelihood method. King Abdullah International Medical Research Center granted the institutional approval.
Our study suggests that while reasons of unavailability of OR time were associated with less frequent same-day surgery cancelation, scheduling issues were linked to more frequent cancelations, compared with reasons for patients being unwell on the day of surgery. Waiting time of more than six hours and morning sessions were associated with less frequent cancelations compared to shorter waiting time and afternoon sessions. Compared to general procedures, specialized clinical procedures were associated with cancelations that are more frequent. Further, female patients were more likely to have more cancelations. Finally, being married was associated with the less frequent cancelation of same-day surgery.
Our findings provide evidence of determinants of the frequency of same-day surgery cancelations. This study draws several important implications for hospitals, especially on optimal utilization of resources and minimization of same-day surgery cancellations. The study also offers several recommendations that we believe will spur future research.
当日手术取消是一个普遍的全球性问题，浪费了宝贵的医院手术室（OR）时间，并造成了巨大的经济成本。在沙特阿拉伯，关于当日手术取消的频率与患者人口统计学、时间相关变量、医疗服务提供者取消手术的原因以及临床程序之间的关联，证据有限。本研究旨在探讨这种关系，了解当地情况。
这是一项回顾性的横截面研究，通过检索病历来检查当日手术取消的频率与包括患者人口统计学、时间相关变量、医疗服务提供者取消手术的原因以及临床程序在内的协变量之间的关系。该数据涵盖了 2014 年 1 月至 12 月在利雅得的法赫德国王国民警卫队医院进行的手术。我们考虑了符合最终分析标准的 440 名患者。如果患者在 12 个月内仅取消了一次手术，则认为取消次数较少，如果患者在同一时期取消了两次或更多次手术，则认为取消次数较多。我们使用描述性统计数据来总结数据，并使用最大似然法的概率回归来估计频率和协变量之间的关联。阿卜杜拉国王国际医学研究中心批准了机构的认可。
我们的研究表明，虽然 OR 时间不足是导致当日手术取消频率较低的原因，但与手术当天患者身体不适的原因相比，调度问题与更频繁的取消有关。与等待时间较短和下午时段相比，等待时间超过 6 小时和上午时段与较少的取消有关。与一般程序相比，专业的临床程序与更频繁的取消有关。此外，女性患者更有可能有更多的取消。最后，已婚与当日手术取消频率较低有关。
我们的研究结果提供了当日手术取消频率的决定因素的证据。这项研究为医院提供了一些重要的启示，特别是在优化资源利用和尽量减少当日手术取消方面。该研究还提出了我们认为将促进未来研究的一些建议。
